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Source: VA State Licensing Agency
Type of inspection: Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 5/15/2025 from 8:50 a.m. to 2:00 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 33 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4 Number of staff records reviewed: 4 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 3 Observations by licensing inspector: The Licensing Inspector observed the residents during activities and meals. The Licensing Inspector reviewed the following at the time of inspection: fire drills, emergency drills, resident council reports, pharmacy review, healthcare oversight, menus, and activity calendars. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jessica Gale, Licensing Inspector at (540) 571-0358 or by email at Jessica.Gale@dss.virginia.gov
Based on direct observation the facility failed to store cleaning supplies and other hazardous materials in a locked area. Evidence: 1. During the facility tour completed 5/15/2025, two licensing staff observed five, one-gallon containers of laundry detergent in an unlocked laundry room, and one, five gallon container of kerosene outside of the facility next to the resident smoking area. 2. Photo evidence taken.
Based on record review and staff interview, the facility failed to ensure the preliminary plan of care was signed by the resident or his legal representative. Evidence: 1. Record review completed 5/15/2025 for resident 1 (admitted 5/13/2025) included a preliminary plan of care that was not signed by the resident or legal representative. 2. During an interview with staff 7, when asked if there was a preliminary plan of care signed for resident 1, staff 7 stated ?no it?s not?.
Based on record review and staff interview the facility failed to ensure direct care staff are at least 18 years of age unless certified in Virginia as a nurse aide. Evidence: 1. Record review for staff 6, hired 2/11/2025 as a direct care aide, indicated staff 6 was not 18 years of age and was not certified in Virginia as a nurse aide. 2. During an interview with staff 1, when asked if staff 6 was 18 years of age or certified in Virginia as a nurse aide, staff 1 stated ?no [staff 6] is not, I wasn?t aware that they had to be 18?.
Based on direct observation and staff interviews the facility failed to ensure that the buildings were kept free of insects. Evidence: 1. During the facility tour completed 5/15/2025, two licensing staff observed an abundance of flies throughout the facility in resident living areas, dining areas, and the food storage area. 2. During the facility tour completed 5/15/2025, two licensing staff observed one hanging fly trap in a resident hallway and one hanging fly trap outside of the facility in the resident smoking area. 3. During an interview with staff 1, staff 2, and staff 7, when asked why there were an abundance of flies in the facility, staff 2 stated that the flies entered through the door leading to the resident smoking area. Staff 1 stated that the staff are aware of the abundance of flies and spray fly spray every night when the residents are in their rooms.
Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 06/05/2024 08:30am-04:30pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 31 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4 Number of staff records reviewed: 3 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 2 Observations by licensing inspector: The Licensing Inspector observed the residents during activities, meals and in their apartments. The following were reviewed at the time of inspection: Menus, activity calendars, fire drills, emergency drills, resident council minutes, dietician report, healthcare oversight. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jessica Gale, Licensing Inspector at 540-571-0358 or by email at Jessica.gale@dss.virginia.gov
Based on record review and staff interview, the facility failed to ensure a criminal history report was completed within required timeframe. Evidence: 1. Based on record review 9 of 11 new hire records did not have a criminal history report completed within 30 days of hire.
Based on direct observation during facility tour and staff interview, the facility failed to ensure the rights and responsibilities of residents are posted conspicuously in a public place. Evidence: 1. Two licensing inspectors did not observe the rights and responsibilities of residents posted in the facility. 2. Staff 1 stated during the interview ?It?s not posted?
Based on direct observation the facility failed to ensure the fire evacuation drawing included all required information. Evidence: 1. Two licensing inspectors observed the fire evacuation drawing that did not include the secondary escape route, areas of refuge, or telephones. 2. Photo evidence taken.
Based on record review the facility failed to ensure the rights and responsibilities of residents are reviewed annually with each resident and each staff person. Evidence: 1. Upon request the facility did not provide documentation of an annual review of the Rights and Responsibilities of residents for staff 5 (Hire date 4/9/2012) 2. The most current annual review of resident rights in Staff 5's record was dated 3/14/2022.
Based on record review and staff interview the facility failed to implement a semi-annual review on the emergency preparedness and response plan for all staff, residents, and volunteers, with emphasis placed on an individual's respective responsibilities. Evidence: 1. Upon request the facility did not provide documentation of a semi-annual review of the emergency preparedness and response plan for all staff and residents. 2. Staff 1 stated during the interview ?we haven?t done that?
Based on record review the facility failed to ascertain, prior to admission, whether a potential resident is a registered sex offender. Evidence: 1. Resident 3 admitted 10/10/2023 has a sex offender search in their record dated 12/5/2023. 2. Resident 4 admitted 1/3/2024 has a sex offender search dated 1/22/2024.
Based on record review and staff interview the facility failed to ensure medications were administered in accordance with the physician's or other prescriber?s instructions. Evidence: 1. Resident 2 has a physicians order dated 5/22/2024 that states ?Clindamycin HCL 300 MG capsule, take 1 capsule 3 times a day by oral route for 7 days? 2. The Medication administration record for Resident 2 indicates Clindamycin 300 MG capsule administered at 7pm on 5/22/2024, 7am, 1pm, 7pm on 5/23/2024, 7am and 7pm on 5/24, 7am, 1pm and 7pm on 5/25-5/27, and 7am and 1pm on 5/28. There is no record of administration for 1pm on 5/24 and no record of any administration on 5/29/2024. 3.Staff 2 stated ?the order was stopped too soon?
Based on record review, the facility failed to ensure the physical examination was completed within 30 days preceding admission. Evidence: 1. Resident 4 admitted 1/3/2024 has a physical exam dated 1/23/2024.
Based on direct observation the facility failed to ensure the current month's schedule is posted in a conspicuous location. Evidence: 1. Two licensing inspectors observed on the day of inspection, the activity calendar posted in the facility reflected the ?May 2023? schedule. 2. Staff 2 stated ?I thought I posted June? 3. Photo evidence taken
Based on record review and staff interview, the facility failed to register with the Department of State Police to receive notice of the registration or reregistration of any sex offender within the same or a contiguous zip code area in which the facility is located, pursuant to ? 9.1-914 of the Code of Virginia. Evidence: 1. The facility failed to provide receipt of notification of the registration or reregistration of any sex offender in the area. 2. Staff 1 stated ?I don?t get those?
Based on direct observation, the facility failed to ensure all resident records are kept in a locked area. Evidence: 1. Two licensing inspectors observed an unlocked cabinet in the upstairs common area containing resident records. 2. Photo evidence taken.
Based on record review and staff interview, the facility failed to ensure the Individualized Service Plan ( ISP
Based on record review and staff interview the facility failed to ensure that each resident or his legal representative is fully informed annually, that he should exercise whatever due diligence he deems necessary with respect to information on any sex offenders registered pursuant to Chapter 9 (? 9.1-900 et. seq.) of Title 9.1 of the Code of Virginia, including how to obtain such information. 1. The facility failed to provide documentation of annual receipt of information pertaining to the sex offender registry and how to obtain such information. 2. Staff 1 stated ?we haven?t done that?
Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 3/7/23 The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 32 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Noted new construction for movement of office within the building. Number of resident records reviewed: 5 plus discharge Number of staff records reviewed: 5 ? one staff had just quit Number of interviews conducted with residents: 3 Number of interviews conducted with staff: 2 plus one collateral case manager. Observations by licensing inspector: Meals activities as outlined. No concerns from residents. Facility notes continues to have issues getting psych notes from provider but do have documentation of maintaining appointments. Additional Comments/Discussion: Fire inspector due in March ? last inspection was 3/16/2023. All other outside inspections current including required drills. The facility has contracted with a nurse consultant (also a licensed administrator) to assist with health care oversight and to assist in updating other relevant procedural information. The evidence gathered during the inspection determined no violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website within five (5) business days of your receipt of the inspection summary. The department's inspection findings are subject to public disclosure. An exit meeting was conducted to review the inspection findings. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. Should you have any questions, please contact Sharon DeBoever, Licensing Inspector at (540) 292-5930 or by email at sharon.deboever@dss.virginia.gov
This mandated monitoring inspection was conducted on site. The facility was found to be clean and odor free. All required postings were available to residents and families. Outside inspections were complete and follow up was done as applicable. Emergency drills including fire, resident and weather had been completed. Four staff and four resident files were reviewed. All eight were complete as required by the standards. Additional MAR
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